| 1. |
- Davidson, Sanna, et al.
(författare)
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Microscopic colitis in Denmark and Sweden : incidence, putative risk factors, histological assessment and endoscopic activity
- 2018
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 53:7, s. 818-824
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The significantly higher incidence rates of microscopic colitis (MC) in Denmark compared to Sweden remains unexplained. Methods: Consecutive patients with newly diagnosed MC in the neighbouring regions of Skåne in 2011–2015 and Zealand in 2010–2016 were prospectively identified. Data on large bowel endoscopies and biopsies rates were retrieved. Information on putative factors were obtained from registers and literature. Interobserver agreement between pathologists from both regions on 40 blinded hematoxylin and eosin (H&E)-stained colon biopsies (collagenous colitis (CC), lymphocytic colitis (LC), non-specific inflammation and normal) was evaluated using kappa statistics. Results: The mean annual incidence per 105 inhabitants in Skåne and Zealand 2010–2015 was 5.9 (95% CI 4.6–7.3) versus 16.4 (95% confidence intervals (95% CI) 13.6–19.2) for CC and 2.7 (95% CI 1.0–4.3) versus 11.1 (95% CI 8.8–13.4) for LC, respectively. Number of endoscopies with biopsy per 1000 and the rate of MC per endoscopy with biopsy was higher in Zealand (34–52/1000) than in Skåne (12–21/1000). The kappa value for overall agreement between pathologists was good (0.72; 95% CI 0.64–0.79). Prescription of proton pump inhibitors and selective serotonin reuptake inhibitors was higher in Skåne in the relevant age groups and prescription of non-steroidal anti-inflammatory drugs and smoking rate higher in Zealand. Alcohol consumption was higher in Denmark than in Sweden. Conclusion: The incidence of MC and number of cases per colonic biopsy was higher in Zealand and could not be readily explained by endoscopy or biopsy rates, differences in histological assessment or putative risk factors.
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| 2. |
- Eriksson, Carl, 1981-, et al.
(författare)
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Long-term effectiveness of vedolizumab in inflammatory bowel disease : a national study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)
- 2017
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Ingår i: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708. ; 52:6-7, s. 722-729
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Clinical trials have demonstrated the efficacy of vedolizumab in inflammatory bowel disease (IBD). However, these findings may not reflect the clinical practice. Therefore, we aimed to describe a vedolizumab-treated patient population and assess long-term effectiveness.Materials and methods: Patients initiating vedolizumab between 1 June 2014 and 30 May 2015 were identified through the Swedish National Quality Registry for IBD. Prospectively collected data on treatment and disease activity were extracted. Clinical remission was defined as Patient Harvey Bradshaw index<5 in Crohn's disease (CD) and Patient Simple Clinical Colitis Activity index<3 in ulcerative colitis (UC).Results: Two-hundred forty-six patients (147CD, 92 UC and 7 IBD-Unclassified) were included. On study entry, 86% had failed TNF-antagonist and 48% of the CD patients had undergone1 surgical resection. After a median follow-up of 17 (IQR: 14-20) months, 142 (58%) patients remained on vedolizumab. In total, 54% of the CD- and 64% of the UC patients were in clinical remission at the end of follow-up, with the clinical activity decreasing (p<.0001 in both groups). Faecal-calprotectin decreased in CD (p<.0001) and in UC (p=.001), whereas CRP decreased in CD (p=.002) but not in UC (p=.11). Previous anti-TNF exposure (adjusted HR: 4.03; 95% CI: 0.96-16.75) and elevated CRP at baseline (adjusted HR: 2.22; 95% CI: 1.10-4.35) seemed to be associated with discontinuation because of lack of response. Female sex was associated with termination because of intolerance (adjusted HR: 2.75; 95% CI: 1.16-6.48).Conclusion: Vedolizumab-treated patients represent a treatment-refractory group. A long-term effect can be achieved, even beyond 1 year of treatment.
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| 3. |
- Hadid, Lina Z, et al.
(författare)
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Ring Shadowing Effects on Saturn's Ionosphere : Implications for Ring Opacity and Plasma Transport
- 2018
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Ingår i: Geophysical Research Letters. - : AMER GEOPHYSICAL UNION. - 0094-8276 .- 1944-8007. ; 45:19, s. 10084-10092
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Tidskriftsartikel (refereegranskat)abstract
- We present new results obtained by the Radio and Plasma Wave Science Langmuir probe on board Cassini during the Grand Finale. The total direct current sampled by the Langmuir probe at negative bias voltage is used to study the effect of the ring shadows on the structure of the Kronian topside ionosphere. The D and C rings and the Cassini Division are confirmed to be optically thin to extreme ultraviolet solar radiation. However, different responses from the opaque A and B rings are observed. The edges of the A ring shadow are shown to match the A ring boundaries, unlike the B ring, which indicates variable responses to the B ring shadow. We show that the variable responses are due to the ionospheric plasma, more precisely to the longer chemical lifetime of H+ compared to H-2(+) and H-3(+), suggesting that the plasma is transported from the sunlit region to the shadowed one in the ionosphere. Plain Language Summary As Saturn's northern hemisphere experienced summer during the Grand Finale, the planet's northern dayside hemisphere and its rings were fully illuminated by the Sun. However, the southern hemisphere was partly obscured because of the shadows cast by the A and B rings. Using the in situ measurements of the Langmuir probe part of the Radio and Plasma Wave Science investigation on board the Cassini spacecraft, we study for the first time the effect of the ring shadows on Saturn's ionosphere. From the ring shadows signatures on the total ion current collected by the Langmuir probe, we show that the A and B rings are optically thicker (to the solar extreme ultraviolet radiation) than the inner C and D rings and the Cassini Division to the solar extreme ultraviolet radiation. Moreover, we reproduce the boundaries of the A ring and the outer edge of the B ring. Furthermore, observed variations with respect to the inner edge of the B ring imply a delayed response of the ionospheric H+ because of its long lifetime and suggest that the ionospheric plasma is transported from an unshadowed region to a shadowed one in the ionosphere.
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| 4. |
- Hadid, Lina Z, et al.
(författare)
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Saturn's Ionosphere : Electron Density Altitude Profiles and D-Ring Interaction From The Cassini Grand Finale
- 2019
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Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 46:16, s. 9362-9369
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Tidskriftsartikel (refereegranskat)abstract
- We present the electron density (n(e)) altitude profiles of Saturn's ionosphere at near-equatorial latitudes from all 23 orbits of Cassini's Grand Finale. The data are collected by the Langmuir probe part of the Radio and Plasma Wave Science investigation. A high degree of variability in the electron density profiles is observed. However, organizing them by consecutive altitude ranges revealed clear differences between the southern and northern hemispheres. The n(e) profiles are shown to be more variable and connected to the D-ring below 5,000 km in the southern hemisphere compared to the northern hemisphere. This observed variability is explained to be a consequence of an electrodynamic interaction with the D-ring. Moreover, a density altitude profile is constructed for the northern hemisphere indicating the presence of three different ionospheric layers. Similar properties were observed during Cassini's final plunge, where the main ionospheric peak is crossed at similar to 1,550-km altitude. Plain Language Summary The Cassini Langmuir probe measured directly the uppermost layer of Saturn's atmosphere, the ionosphere, during its Grand Finale. The observations revealed a layered electron density altitude profile with evidence in the southern hemisphere of an electrodynamic type of interaction with the planet innermost D-ring. Moreover, the main peak of the ionosphere is observed for the first time in the final plunge around 1,550 km.
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| 5. |
- Morooka, Michiko, et al.
(författare)
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Saturn's Dusty Ionosphere
- 2019
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Ingår i: Journal of Geophysical Research - Space Physics. - : American Geophysical Union (AGU). - 2169-9380 .- 2169-9402. ; 124:3, s. 1679-1697
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Tidskriftsartikel (refereegranskat)abstract
- Measurements of electrons and ions in Saturn's ionosphere down to 1,500-km altitudes as well as the ring crossing region above the ionosphere obtained by the Langmuir probe onboard the Cassini spacecraft are presented. Five nearly identical deep ionosphere flybys during the Grand Finale orbits and the Final plunge orbit revealed a rapid increase in the plasma densities and discrepancies between the electrons and ions densities (N-e and N-i) near the closest approach. The small N-e/N-i ratio indicates the presence of a dusty plasma, a plasma which charge carrier is dominated by negatively charged heavy particles. Comparison of the Langmuir probe obtained density with the light ion density obtained by the Ion and Neutral Mass Spectrometer confirmed the presence of heavy ions. An unexpected positive floating potential of the probe was also observed when N-e/N-i << 1. This suggests that Saturn's ionosphere near the density peak is in a dusty plasma state consisting of negatively and positively charged heavy cluster ions. The electron temperature (T-e) characteristics in the ionosphere are also investigated and unexpectedly high electron temperature value, up to 5000 K, has been observed below 2,500-km altitude in a region where electron-neutral collisions should be prominent. A well-defined relationship between T-e and N-e/N-i ratio was found, implying that the electron heating at low altitudes is related to the dusty plasma state of the ionosphere.
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| 6. |
- Nyberg, Lisa, et al.
(författare)
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Sclerosing mesenteritis and mesenteric panniculitis - clinical experience and radiological features
- 2017
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Ingår i: BMC Gastroenterology. - : Springer Science and Business Media LLC. - 1471-230X. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sclerosing mesenteritis (SM) is sometimes used as an umbrella-term for idiopathic inflammatory conditions in the mesentery. Mesenteric panniculitis (MP) is a radiological finding and its relation to clinical SM is not fully understood. The aims of this study were to determine whether any correlation could be found between the radiological findings and the clinical disease course. Methods: Patients observed due to idiopathic inflammation of the mesentery were identified. If SM could be verified histologically or MP radiologically, the patients were included in this descriptive retro perspective study. Results: Typical radiological changes were observed in 27 patients. A majority (23/27) of these patients had mild to moderate symptoms. This group with typical radiology was labelled MP. Four patients were included due to histologically verified disease but had uncharacteristic radiology involving multiple compartments of the abdomen. All four had marked systemic inflammation, fever and fluctuating radiologic findings. Three had severe disease with multiple hospitalisations and complications but responded promptly to corticosteroids. This group was denoted SM. Conclusions: We have identified two subgroups of patients; firstly, MP with stable and characteristic radiologic changes and secondly SM with atypical radiology and a more aggressive clinical course. We propose that the term SM should be reserved for this latter condition.
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| 7. |
- Wagner, Michael, et al.
(författare)
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Elevated fecal levels of eosinophil granule proteins predict collagenous colitis in patients referred to colonoscopy due to chronic non-bloody diarrhea
- 2016
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 51:7, s. 835-841
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Colonoscopy with biopsy sampling is often performed to detect collagenous colitis (CC) and lymphocytic colitis (LC) in patients with chronic non-bloody diarrhea. However, the diagnostic yield is low and incurs high costs. Fecal calprotectin (FC) and myeloperoxidase (MPO) indicate intestinal inflammation in ulcerative colitis (UC) and Crohn's disease (CD). In CC, elevated fecal levels of eosinophil protein X (EPX) and eosinophil cationic protein (ECP) have been reported. We aimed to evaluate if F-EPX, F-ECP, FC, and F-MPO could predict the diagnostic outcome in patients with chronic non-bloody diarrhea referred to colonoscopy. We also evaluated serum (S) EPX and ECP in this regard. Methods: Of 67 included patients, 63 (94%) underwent colonoscopy with biopsy sampling. Fecal EPX, F-ECP, FC, F-MPO, S-EPX, and S-ECP were analyzed. Results: Diagnostic outcome: normal: n = 46 (73%), CC: n = 9 (14%), LC: n = 4 (6%), UC: n = 2 (3%), CD: n = 2 (3%). Higher levels of F-EPX and F-ECP were found in CC compared to a normal diagnostic outcome (p = 0.01). No change was noted in any of the fecal markers in LC. When all of the fecal markers were normal the probability of a normal diagnostic outcome was 92%. We found no differences in S-EPX and S-ECP between the groups. Conclusion: Elevated F-EPX and F-ECP could predict CC. None of the fecal markers predicted LC. Serum-EPX and S-ECP are not useful for the diagnosis of CC, LC, UC, or CD. With normal levels in all of the analyzed fecal markers, there is a low probability of a pathologic diagnostic outcome.
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| 8. |
- Wahlund, Jan-Erik, et al.
(författare)
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In situ measurements of Saturn's ionosphere show that it is dynamic and interacts with the rings
- 2018
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 359:6371, s. 66-68
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Tidskriftsartikel (refereegranskat)abstract
- The ionized upper layer of Saturn's atmosphere, its ionosphere, provides a closure of currents mediated by the magnetic field to other electrically charged regions (for example, rings) and hosts ion-molecule chemistry. In 2017, the Cassini spacecraft passed inside the planet's rings, allowing in situ measurements of the ionosphere. The Radio and Plasma Wave Science instrument detected a cold, dense, and dynamic ionosphere at Saturn that interacts with the rings. Plasma densities reached up to 1000 cubic centimeters, and electron temperatures were below 1160 kelvin near closest approach. The density varied between orbits by up to two orders of magnitude. Saturn's A- and B-rings cast a shadow on the planet that reduced ionization in the upper atmosphere, causing a north-south asymmetry.
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| 9. |
- Wickbom, Anna, 1970-, et al.
(författare)
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Microscopic colitis in patients with ulcerative colitis or Crohns disease: a retrospective observational study and review of the literature
- 2018
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Ingår i: Scandinavian Journal of Gastroenterology. - : TAYLOR & FRANCIS LTD. - 0036-5521 .- 1502-7708. ; 53:4, s. 410-416
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Onset of microscopic colitis (MC) in patients with ulcerative colitis (UC) or Crohns disease (CD), or vice versa, has been reported occasionally but the subject is not well described. We therefore report a retrospective observational study of such patients and review the literature.Methods: Forty-six Swedish gastroenterology clinics were contacted about patients with diagnoses of both inflammatory bowel disease (IBD) and MC. Publications were searched on PubMed.Results: We identified 31 patients with onset of MC after a median (range) of 20 (2-52) years after diagnosis of IBD, or vice versa; 21 UC patients developed collagenous colitis (CC) (n=16) or lymphocytic colitis (LC) (n=5); nine CD patients developed CC (n=5) or LC (n=4); one CC patient developed CD. Of the 21 UC patients, 18 had extensive disease, whereas no consistent phenotype occurred in CD. Literature review revealed 27 comprehensive case reports of patients with diagnoses of both IBD and MC. Thirteen MC patients developed IBD, of which four required colectomy. Fourteen IBD patients later developed MC. There were incomplete clinical data in 115 additional reported patients.Conclusions: Altogether 173 patients with occurrence of both IBD and MC were found. The most common finding in our patients was onset of CC in a patient with UC. Although these are likely random associations of two different disorders, MC should be considered in the patient with UC or CD if there is onset of chronic watery diarrhoea without endoscopic relapse of IBD.
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